Pluvicto

(vipivotide tetraxetan)
12.5 ML lutetium Lu 177 vipivotide tetraxetan 27 MCI/ML Injection [Pluvicto]
NO BOXED WARNING

Dosage & administration

drug label

Pluvicto prescribing information

prior authorization

Pluvicto prior authorization resources

Most recent Pluvicto prior authorization forms

View By Payer
Verified: Feb 07, 2024Kaiser Foundation Health Plan - Chronic High-Dose Opioid Therapy Prior Authorization Form Washington
Verified: Mar 02, 2024Highmark BCBS Northeastern NY - Medicare Prescription Drug Medication Request Form
Verified: Mar 02, 2024Highmark BCBS Northeastern NY - Short Acting Opioid Prior Authorization Form
Verified: Mar 02, 2024Highmark BCBS Western NY - Specialty Drug Prior Authorization Form
Verified: Mar 02, 2024Highmark BCBS Western NY - Non-Formulary Drug Coverage Prior Authorization Form

Most recent state uniform prior authorization forms

Verified: Feb 27, 2024Arizona - Uniform Prior Authorization Form
Verified: Feb 27, 2024Colorado - Uniform Prior Authorization Form
Verified: Feb 27, 2024Hawaii - Uniform Prior Authorization Form
Verified: Feb 27, 2024Illinois - Uniform Prior Authorization Form
Verified: Feb 27, 2024Indiana - Uniform Prior Authorization Form
Verified: Feb 27, 2024Louisiana - Uniform Prior Authorization Form
Verified: Feb 27, 2024Michigan - Uniform Prior Authorization Form
Verified: Feb 27, 2024Minnesota - Uniform Prior Authorization Form
Verified: Feb 27, 2024New Hampshire - Uniform Prior Authorization Form
Verified: Feb 27, 2024New Mexico - Uniform Prior Authorization Form
Verified: Feb 27, 2024Oregon - Uniform Prior Authorization Form
Verified: Feb 27, 2024Texas - Uniform Prior Authorization Form
Coverage Authorization Appeals
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Benefits investigation

AAA PatientCONNECT Pluvicto Enrollment Form
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financial assistance

Pluvicto financial assistance options

Co-pay savings program

commercial only
AAA PatientCONNECT Pluvicto Enrollment Form
Enroll in Patient Savings Program
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Foundation programs

under insured
no insurance
goverment insurance
65+
AAA PatientCONNECT Pluvicto Enrollment Form
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PubMed™ | Pluvicto

Pluvicto PubMed™ News

patient education

Pluvicto patient education

To share resource; ask patient to:
1.Pull out phone
2.Open camera
3.Scan QR code with camera
4.Tap link

Patient toolkit

Patient Brochure
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
AAA PatientCONNECT Patient Brochure
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
About Pluvicto
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Receiving Pluvicto
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Side Effects
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Patient Stories
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Scan QR Code & Tap Link
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people also ask

Pluvicto FAQs

How is the dosage of Pluvicto?Pluvicto is available in 1 dosages, including 177-27 var units Injection 12.5 ml
What does Pluvicto treat?Pluvicto treats Prostatic Neoplasms
How Is Pluvicto Administered?Pluvicto is administered as a Injectable
FAQ Data Source